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Can someone help? Or point me somewhere in understanding the differences? Safety in long term use? What is commonly prescribed for SM dogs? Side effects of either?

Thank you!!!

Omeprazole (Prilosec, Losec, Omesec, Zegerid) is a proton pump inhibitor which reduces the production of cerebrospinal fluid.

Cimetidine (Tagamet, Zitac) is a histamine H2-receptor antagonist -- an antihistamine. Histamine contributes to inflammation and causes smooth muscles to constrict. Cimetidine is diffused into the cerebrospinal fluid and reportedly may contribute to reducing the flow of CSF. When taken with gabapentin, cimetidine also reportedly may increase the amount of gabapentin in the blood by decreasing its elimination. Therefore, when taken together, the dosages may require adjustment.

I asked the vet the same thing but wasn't really listened to. one of our dogs has very bad CM so I wondered whether a slight widening from the relaxed muscles would actually make any difference in such a severely affected dog. she's still going to be very pinched at the base of her skull. maybe omperezol would have worked better?